1

District Manual for

Managing CLTS in

Small Towns

COMMUNITY WATER AND SANITATION AGENCY (CWSA) /

ENVIRONMENTAL HEALTH AND SANITATION DIVISION (MOH)

NORTHERN REGION SMALL TOWNS WATER & SANITATION PROJECT

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Credits The DISTRICT MANUAL FOR MANAGING CLTS IN SMALL TOWNS is a guide for district

managers and other stakeholders in planning and developing CLTS programs in small towns.

The manual was written by Ross Kidd, with the help of: Stephen Adongo (Regional Environmental

Health Officer, Northern Region), Gaeten Kuupuolo (Extension Services Specialist – Hygiene

Education, CWSA Northern Region), Mary Liao, Andrew Livingstone, Korblaah Matanawi, Simon

Mead, K. Modoc (APDO), Stephen Ntow, Alex Opare-Akonor, Susana Sandoz, and Loretta

Roberts (UNICEF).

Graphics were produced by Petra Rohr-Rouendaal and Ato de Graft.

The manual is based on information drawn from:

a) Final Report – Community Led Total Sanitation in Small Towns: A Pilot Project in the Northern

Region of Ghana (Cowater International)

b) Report on Health and Hygiene Education through Play and Sport (HHETPS), a pilot project

supporting the CLTS Pilot Project in Northern Region, Ghana (Cowater International)

The manual also draws on the ideas and experience of regional and district managers who

participated in the pilot CLTS project which was implemented in Bincheratanga and Karaga.

The manual is one of the support manuals developed for the Northern Region Small Towns Water

and Sanitation Project. It will be used by District Assemblies, Environmental Health & Sanitation

Units, CWSA, and Water & Sanitation Management Units to implement CLTS in other towns of

the Northern Region.

We would like to acknowledge the following documents as sources of information on sanitation in

Ghana:

Aquaconsult and Maple Consult (2011) ‘Development of a Rural Sanitation Strategy and Model

for Ghana: Rural Sanitation Model and Costed Scaling up Strategy for Community Led Total

Sanitation and Hygiene in Ghana’. UNICEF and Government of Ghana.

Aquaconsult and Maple Consult (2011) ‘Development of a Rural Sanitation Strategy and Model

for Ghana: District Resource Book for Scaling up Community Led Total Sanitation and Hygiene

and Social Marketing in Ghana: A District Handbook’. UNICEF and Government of Ghana.

Bevan, Jane and Thomas, Ann (2009) ‘Community Approaches to Total Sanitation: Triggering

and Sustaining Sanitation Behaviour Change in West Africa’. Paper delivered to the West Africa

Regional Sanitation and Hygiene Symposium, Accra, Ghana, 3-5 November 2009

Demedeme, N. L., and P. Nutsugah (2009) ‘Evaluation of Community Led Total Sanitation

(CLTS) in Ghana’ Paper delivered to the West Africa Regional Sanitation and Hygiene

Symposium, Accra, Ghana, 3-5 November 2009

Kar, Kamal (2011). ‘Introducing CLTS in Africa: Implementation and Spread’ in L. Mehta and S.

Movik Shit Matters: The Potential of Community-Led Total Sanitation. London, Practical Action.

Magala, Joyce Mpalanyi and Roberts, Lorretta (2009) Evaluation of Strategy for Scaling up

Community Led Total Sanitation in Ghana: Final Report. Accra: UNICEF

UNICEF WCARO (2011) Roll Out Evaluation of Community Led Total Sanitation in West and

Central Africa: Final Report. UNICEF West & Central Africa Region

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CONTENTS

Credits ........................................................................................................................................................2

Foreword ....................................................................................................................................................4

Abbreviations.............................................................................................................................................5

Glossary .....................................................................................................................................................6

Chapter 1 – Introduction ...........................................................................................................................7

1.1 What is Community Led Total Sanitation? ................................................................................7

1.2 No Subsidy and Self-Reliance Approach..................................................................................8

1.3 CLTS as a Small Town Strategy ............................................................................................. 10

1.4 Why Sanitation in Small Towns of Northern Region?............................................................ 10

1.5 National Sanitation Policy ........................................................................................................ 11

1.6 Strategies for CLTS in Small Towns....................................................................................... 12

Chapter 2 - Players, Roles, and Relationships ................................................................................... 14

2.1 Introduction................................................................................................................................. 14

2.2 DA Executive & Core Staff ...................................................................................................... 15

2.3 District Environmental Health Officer ...................................................................................... 15

2.4 Environmental Health & Sanitation Unit (EHSU) ................................................................... 16

2.5 District Water & Sanitation Team (DWST) ............................................................................ 16

2.6 District Assembly Members..................................................................................................... 17

2.7 District Inter-Agency Coordinating Committee ...................................................................... 17

2.8 Traditional Leaders, Area Council and Unit Committees..................................................... 18

2.9 Water & Sanitation Management Team (WSMT) ................................................................. 18

2.10 Community ............................................................................................................................. 19

2.11 Community Facilitators ......................................................................................................... 19

2.12 Natural Leaders ..................................................................................................................... 19

2.13 Sanitation Service Providers ............................................................................................... 20

2.14 Development Partners .......................................................................................................... 20

Chapter 3 - Managing CLTS Program in Small Towns: Project Cycle ............................................ 22

3.1 Introduction................................................................................................................................. 22

3.2 Build Support within District Assembly ................................................................................... 24

3.3 Orient Stakeholders and Establish Inter-Agency Coordinating Committee ....................... 25

3.4 Community Promotion to Trigger Demand ............................................................................ 27

3.5 Application and Action by Community .................................................................................... 29

3.6 Selection of Small Towns ......................................................................................................... 30

3.7 Selection and Training of CLTS Facilitators .......................................................................... 32

3.8 Pre-Triggering Planning Meeting (Town Level) and Baseline Data Collection.................. 34

3.9 Sectional Triggering Meetings ................................................................................................ 35

3.10 Post-Triggering Follow-up Support/Monitoring .................................................................. 37

3.11 ODF Verification, Declaration & Celebration..................................................................... 40

3.12 Sanitation Marketing ............................................................................................................. 41

3.13 Monitoring, Evaluation, and Reporting ................................................................................ 42

ANNEX A: Level 1 Verification Towards ODF Declaration ......................................................... 44

ANNEX B: Do and Don’ts of CLTS in Small Towns ...................................................................... 46

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Foreword

Welcome to the District Manual for Managing Community Led Total Sanitation (CLTS) in Small

Towns. The manual is written for all of the stakeholders at the district level who are involved in

promoting sanitation in small towns using the CLTS approach. It will tell you all of the things you

need to know to plan and implement your own sanitation program.

The Manual is divided into three chapters:

CHAPTER 1 is an introduction to CLTS. It will explain CLTS and its goals and strategies.

CHAPTER 2 looks at PLAYERS and their ROLES. It looks at each of the stakeholders involved

in sanitation at district and community levels and explains their functions in implementing CLTS.

CHAPTER 3 introduces the PROJECT CYCLE - how to organise each step in the process of

planning and implementing a CLTS program in the small towns of the district.

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ABBREVIATIONS APDO Afram Plains Development Organisation

CFT Community Facilitation Team

CLTS Community Led Total Sanitation

COM Community Ownership and Management

CWSA Community Water and Sanitation Agency

DA District Assembly

DCD Department of Community Development

DCDO District Community Development Officer

DCE District Chief Executive

DED District Executive Director

DEHWC Education, Health, & Water Committee (Assembly)

DEHO District Environmental Health Officer

DESSAP District Environmental Sanitation Strategy and Plan

DFT District Facilitation Team

DICC District Inter Agency Coordinating Committee

DPLO District Planning Officer

DWSP District Water & Sanitation Plan

DWST District Water and Sanitation Team

EHSU/D Environmental Health and Sanitation Unit/Division

EPA Environmental Protection Agency

GHS Ghana Health Service

HHETPS Health & Hygiene Education through Play and Sports

ISD Information Services Department

LGA Local Government Authority

M&E Monitoring and Evaluation

MMDA Metropolitan, Municipal, and District Assemblies

MOH Ministry of Health

NL Natural Leader

NORST Northern Region Small Towns Water & Sanitation (Project)

OD Open Defecation

ODF Open Defecation Free

PLWD Person Living with Disability

RPCU Regional Planning and Coordination Unit

RTP Right to Play

SHEP School Health Education Programme

SLTS School Led Total Sanitation

WASH Water Sanitation and Hygiene

WSMT Water and Sanitation Management Team

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GLOSSARY Community-led Total Sanitation (CLTS) is a method used by communities to achieve Open

Defecation Free (ODF) status, by building latrines and ensuring all families wash their hands with

soap. In the CLTS process a community analyses its practices of defecation and how open

defecation leads to disease, and this awareness leads to a community decision to change their

sanitation situation - to stop open defecation and improve sanitation and hygiene.

Faecal-oral transmission is the route by which disease-causing organisms excreted in the

faeces of infected humans enter the human body through the mouth. Such organisms may be

carried from faeces to mouth via contaminated fingers, food, flies, fluids (e.g. water) or soil.

Hygiene is the practice of keeping oneself and one’s surroundings clean in order to prevent the

spread of disease. It includes the proper use of water and sanitation facilities and practices to

prevent transmission of diseases, including use of latrines; washing hands at critical times, etc.

Hygienic latrine: A hygienic latrine does not contaminate water bodies, prevents contact

between human beings and excreta, confines excreta in ways that make it inaccessible to flies,

other insect vectors, and domestic or wild animals; and prevents emission of foul odours.

Ignition is the result of ‘triggering’ (see definition below). The community realises their sanitation

situation and goes immediately into action. This happens to varying degrees depending on the

community’s feelings about open defecation and the quality of facilitation.

Natural Leaders (NLs) are community members who volunteer to help improve sanitation in their

community. They emerge out of the triggering process – they take responsibility for leading the

follow-up action process. Men, women, youth and children can all be natural leaders. Some

become facilitators for CLTS facilitation in communities other than their own.

OD means open defecation – defecating in the open and leaving the faeces exposed.

Open Defecation Free (ODF) means that no faeces are deposited in the open - every family in

the community is now using their own latrine.

Sanitation is a process where people demand, develop, and sustain a hygienic and healthy

environment for themselves by erecting barriers to prevent the transmission of disease. (UNICEF,

1997) It includes the development of facilities such as latrines, handwashing facilities, bath

shelters, dish racks, refuse pits, water storage containers, soak-a-ways, etc.

Sanitation marketing is to create demand and facilitate supply using commercial methods

including the use of formative research to inform behaviour change and creative use of public

finance to facilitate private sector engagement

Triggering is the process of encouraging, empowering, igniting, and supporting people at

household and community levels to take action to eliminate open defecation.

Verification refers to inspection to assess whether a community is ODF (compare certification).

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1. Chapter 1 – Introduction

1.1 What is Community Led Total Sanitation?

CLTS is a process to inspire and empower communities to completely eliminate open defecation

and to make improvements in hygiene and sanitation. Communities come together to discuss the

problem of open defecation and decide what they want to do about it.

CLTS focuses primarily on changing sanitation and hygiene behaviours, rather than constructing

toilets. It recognises that simply building toilets does not mean that people will use them. People

need to understand WHY they need toilets as a trigger for building toilets and then using them.

Open defecation (OD) is the first behaviour to be changed, as stopping OD is the most effective

behaviour for reducing diarrhoeal disease. Community members analyse their own practice of

open defecation and come to realise that open defecation is disgusting and dangerous.

The breakthrough or ‘trigger” for stopping open defecation is when people realise and begin to

say -

We are eating our own shit and our neighbours’ shit!

Once community members realize that they are eating their own shit, they take immediate action

to stop open defecation and to build and use toilets. Households dig pits and build latrines, using

local resources and their own labour, and neighbours help neighbours. Through their collective

efforts they build lots of toilets and achieve Open Defecation Free (ODF) status.

Why do we get communities to stop open defecation? Improved toilet coverage in Ghana is very low; available toilets are in poor condition and many

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are not used; and most people go to the bush for defecation rather than using a toilet.

Open defecation creates many problems:

It pollutes the water supply and environment and results in diarrhoea and other diseases.

The high incidence of diarrhoea in infants under five years accounts for 25% of the child

mortality rate. Diarrhoea is strongly linked to inadequate sanitation and hygiene.

There are also strong links between poor sanitation, intestinal worms and malnutrition, whose

combined effects make young children easily get diseases like pneumonia, malaria and

measles, and can lead to lower school and work productivity, and reduced learning capacity.

There are also strong links between sanitation and hygiene and women’s reproductive health.

If women do not get sick from diarrheal diseases, then they will produce healthier babies and

be able to look after them well.

So stopping open defecation and getting communities to build and use their own toilets

will help to improve health and reduce environmental pollution.

CLTS focuses on the WHOLE COMMUNITY rather than on individual households. It brings men,

women, and children together to discuss and decide what they are going to do about the open

defecation problem and how they can support each other’s efforts to make a change. The

breakthrough comes when the whole community agrees as a community that open defecation is a

problem for everyone – each household’s behaviour affects the whole community. Getting

everyone to stop shitting in the open is important, otherwise those who still shit in the open will

spread shit to those who build and use toilets. Everyone needs to stop shitting in the bush!

1.2 No Subsidy and Self-Reliance Approach CLTs uses a self-reliance approach – so there are no latrine subsidies and CLTS does not

impose standardised latrine models. Households collect their own materials (e.g. poles,

thatching grass and mud) and each household decides itself the kind of latrine it wants to build.

CLTS does NOT provide money for materials or labour to build toilets. Instead households

are encouraged to build their own toilets, using local resources and their own labour. The aim is

to get each household to accept responsibility for financing, building and maintaining

their own toilet, without depending on government.

CLTS does NOT tell people what type of latrine to build. Each household decides itself the

kind of latrine it can afford, build, and maintain. They dig the pit, get the materials, build the

latrine, and then maintain it.

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Why total subsidies for sanitation do not work! If government or donors provide toilets on a free basis, households will not develop an interest in

having their own toilet. They will sit back and wait for government to provide the toilet and when it

breaks down, they will not repair it.

If households focus on getting a subsidy, they will not change their behaviour – they will continue

shitting in the bush and eating shit, while they wait for government to provide the subsidy.

If households depend on government or donors to help finance their latrines, e.g. providing a

subsidy, they may refuse to build a new latrine when the latrine paid for by government is no

longer working. Households have to accept latrine building and maintenance as their own

responsibility and to value its benefits.

Providing long term support for latrine building is expensive and not sustainable. Government

does not have enough funds to provide every household with a toilet, even a very basic

one. So building toilets all over Ghana on a large scale is not possible.

Often subsidies for building toilets are grabbed by the powerful and wealthy and do not reach the

poor who need it most and are often the reason stated for using a subsidy in the first place.

The use of subsidies results in slower sanitation coverage. Households who can afford to

and would have financed their own latrines wait in the hope of getting a subsidy from government.

Yet because there is never enough subsidy to go around, this delay leads to no action at all.

CLTS will focus not only on building and using

toilets. It will also promote handwashing and

other hygiene behaviours. The full list of CLTS

target behaviours includes:

Stop all open defecation

All households have, use, and maintain a

hygienic toilet

All households have, use, and maintain a

handwashing facility

Wash hands with soap at five critical times

- after defecation, after cleaning a child’s

bottom, before preparing food, before feeding

a child, and before eating

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1.3 CLTS as a Small Town Strategy CLTS was developed as a method for rural sanitation. But we

have found that CLTS can also be used in an urban context,

and more specifically in small towns.

The NORST Project carried out a pilot project in two small

towns of the Northern Region – Karaga and Bincheretanga.

This project showed that it is possible to use CLTS

successfully in small towns, but the approach needs to be

adapted to suit the conditions in small towns. There is a need

to make adjustments for the following conditions, which are

different from the village context:

Population pressure – larger numbers of people need to

use sanitation facilities so pits get filled up faster, and

there is a need to empty the toilet or dig new pits.

Lack of space on the plot to dig new pits and problems

related to the emptying of toilets.

Land ownership issues – many residents live on their plots

as tenants, so they are not willing to invest in building

toilets and need to get their landlords to build the toilets.

Community cohesion - small towns usually contain several

tribes and clans (whereas a village may have a single clan

or tribe) so they are less cohesive for working together as

a community.

The larger population of the small town is also a problem. It is not possible to work with the whole

small town as a community – it would be too many people to hold an effective meeting. So the

small town needs to be divided into its neighbourhoods or sections – and the CLTS process

applied to each of these sections, a triggering meeting held in each section. Working in smaller

neighbourhoods makes it easier for people to work together.

1.4 Why Sanitation in Small Towns of Northern

Region? There is a serious need to improve sanitation in the small towns of the Northern Region. Why?

Northern Region is the third lowest region in the country in terms of environmental sanitation.

Over 70% of the urban and rural population practice open defecation.

Roughly 2500 metric tons of human shit is generated daily and deposited in the open.

In towns untreated human excreta from private and public toilets is disposed in open fields.

Those latrines which do exist are poorly cleaned and maintained – so they are breeding

grounds for flies and disease.

Most institutional latrines (especially school facilities) have been vandalised because nearby

compounds have no latrines for household use and thus use the institutional latrines.

Small towns are littered with plastic waste and dry refuse.

Because the residents of small town depend on open defecation or unsafe pit latrines, they

get diseases such as diarrhoea and cholera.

Many people in small towns do not practice hygiene – in particular regular handwashing – as a

daily part of their lives. They may know hygiene messages, but do not practice them.

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All of these situations lead to POOR HEALTH. This lowers their productivity and causes

economic hardship.

1.5 National Sanitation Policy Over 60% of Ghana’s disease burden is considered to be

preventable and primarily caused by poor sanitation and

hygiene practices. This is mainly due to the widespread

practice of open defecation and low levels of latrine

coverage.

The Government of Ghana has recognised the

importance of sanitation and hygiene practices towards

the achievement of poverty reduction, national health

targets and the Millennium Development Goals.

Widespread open defecation and low latrine coverage

are major factors underlying poverty and the national

disease burden, particularly the high incidence of

diarrheal disease in infants under five years which

accounts for 25% of the child mortality rate. The Growth

and Poverty Reduction Strategy (GPRS II) states that

adequate sanitation is necessary to create a clean

environment and prevent infectious diseases such as

diarrhoea and cholera.

The Ghana Water Policy states that increasing sanitation and hygiene levels will:

improve the productive lives of people;

enhance the enrolment of girls in school and women’s dignity;

reduce morbidity and mortality and reduce pre and post-natal risks; and

prevent vector and water borne diseases.

The Government of Ghana has set the following targets for sanitation coverage, i.e. ownership

and use of an improved household latrine - 54% coverage by 2015 and 100% coverage by 2025.

The National Environmental Sanitation Policy (NESP) emphasizes the need for a cost

effective sanitation model based on the CLTS approach. The policy states that “for all rural and

small settlements, the CLTS approach will be adopted”. For urban and large settlements, the

policy directs that environmental assessment and audits be applied in strategic planning.

Ministry of Local Government and Rural Development (MLGRD) is responsible for

implementing the National Environmental Sanitation Policy, more specifically through the

Environmental Health and Sanitation Division (EHSD).

EHSD has developed a National Environmental Sanitation Strategy & Action Plan

(NESSAP), based on District Environmental Sanitation Strategy and Action Plans

(DESSAP) which have been produced by each district. The DESSAPs are linked to the

objectives and strategies in the District Water and Sanitation Plans (DWSPs).

EHSD has produced a Rural Sanitation Model for CLTS and Sanitation Marketing. The

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District Assembly are the primary implementers of the Rural Sanitation Model, working closely

with the private sector. This model provides guidelines for the development of CLTS by each

District Assembly, along with guidelines for the development of a sanitation marketing (SanMark)

strategy at the district level.

Most water and sanitation related diseases can be prevented by

improving the following behaviours:

Building, using and maintaining toilets to dispose of faeces

Washing hands after defecation and before touching food

Keeping drinking water free from faecal contamination

1.6 Strategies for CLTS in Small Towns Responding to demand: The CLTS programme will only assist small towns which make a

written request to participate in the program. At present communities see sanitation and

hygiene as something imposed by outsiders and not as a survival need, like water. The new

approach will get the community to see sanitation and hygiene as a serious issue in their lives

and something they are committed to taking action on.

Active participation in the change process: The old approach to sanitation used one-

way communication and teaching to get people to change. Environmental Health field workers

told people what to do through talks and threats. They talked and talked, but allowed little time

for discussion. Villagers were expected to listen passively, swallow the messages, and put

them into practice. Information conveyed through a one-way process and threats will not bring

about sustained change. The new approach will move people out of a passive role into an

active role of discussing and analyzing the OD situation, deciding what needs to be done,

planning the changes, and then taking action. Since people are coming up with their own

solutions, decisions, and plans, they will be more committed to taking serious action.

Communities working together: A key strategy is the idea of communities working

together to create a hygienic environment that benefits everyone. Communities meet to

analyse the problem of OD, decide what needs to be done, and then support each other to do

it.

Empower women and involve men: Women have the

most to gain from improved sanitation and are often

more receptive to these changes than men; but women

often need the cooperation of men to take action, e.g.

releasing funds to buy latrine materials and providing

labour for construction. Women and men need to be

involved in the discussions on stopping OD and building

toilets, and women need to be allowed to give their ideas

on toilet design. In addition, women need to be

represented equally among Natural Leaders and

Facilitators.

No subsidies: Government will no longer provide

subsidies for materials or labour to build toilets. Each

household will finance its own toilet. This will ensure a

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stronger sense of ownership and a willingness to repair the toilet when it has problems.

District Assembly in the lead: The DA, as the arm of government at the district level, have a

pivotal role to play in promotion, planning, organising the triggering process, and monitoring.

Private sector and NGOs as providers of goods and services: The private sector and

NGOs are expected to provide various services, e.g. training, provision of latrine construction

materials, and the skills to construct latrines.

Focus on Schools: Targeting schools at the same time as communities helps to reinforce

household action. Schools provide an excellent opportunity to encourage positive behaviour

change. Children can learn new habits and then set examples at home. The programme will

also promote school led total sanitation and practical education on hygiene and sanitation.

Sanitation Marketing will be promoted at the district level so that households can access

sanitation materials and skills to help them move up the sanitation ladder.

Community based monitoring can also help to motivate large-scale change. The

community keeps a record of those households who have built latrines. This public record

motivates others to follow this example.

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2. Chapter 2 - Players, Roles, and

Relationships

2.1 Introduction This chapter looks at the players involved in sanitation at district and community levels; their roles

and responsibilities; their reporting relationships; and the other players with whom they

collaborate.

The following players have important roles in the development of sanitation in the small town

context:

1. DA EXECUTIVE AND CORE STAFF

2. DISTRICT ENVIRONMENTAL HEALTH OFFICER

3. ENVIRONMENTAL HEALTH & SANITATION UNIT (EHSU)

4. DISTRICT WATER AND SANITATION TEAM (DWST)

5. DISTRICT ASSEMBLY MEMBERS

6. DISTRICT INTER-AGENCY COORDINATING COMMITTEE (DICC)

7. TRADITIONAL LEADERS, AREA COUNCIL AND UNIT COMMITTEES

8. WATER AND SANITATION MANAGEMENT TEAM (WSMT)

9. COMMUNITY

10. COMMUNITY FACILITATORS

11. NATURAL LEADERS

12. SANITATION SERVICE PROVIDERS (PRIVATE SECTOR)

13. DEVELOPMENT PARTNERS

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2.2 DA Executive & Core Staff Who?

DISTRICT EXECUTIVE consists of:

District Chief Executive (DCE) – political head of DA

District Coordinating Director (DCD) – administrative head of DA

Presiding Member - chairperson of District Assembly

CORE STAFF are other senior officers - Deputy District Coordinating Director (DDCD),

District Planning Officer (DPO), District Finance Officer (DFO), District Budget Officer (DBO),

and District Engineer.

Role Description

The DA Executive are responsible for coordinating and directing the District Assembly’s

business. They provide the leadership for Assembly meetings and manage the planning and

administrative machinery which implements the Assembly’s decisions. They work through the

Environmental Health & Sanitation Unit (EHSU) to implement the district sanitation

programme. So their commitment to the sanitation issue is important: where they are

committed to this issue, they can advocate on its behalf in the Assembly and in community

meetings, and arrange the full backing of relevant departments.

Detailed Tasks:

Guide, support, and monitor the work of the EHSU

Lobby the support of chiefs, DA members, WSMTs, and other community leaders

Special Note:

Since the DA Executive members are very busy people, it is important that the EHSU keeps

them regularly briefed about sanitation issues and involves them in specific sanitation

activities (e.g. giving updates on sanitation in the District Assembly, attending ODF

celebration meetings, lobbying the support of chiefs and other community leaders, etc.)

2.3 District Environmental Health Officer Who?

DISTRICT ENVIRONMENTAL HEALTH OFFICER is the head of the EHSU.

Role Description:

The DEHO provides the overall leadership for sanitation activities in the district. As a senior

officer in the DA, the DEHO has the status to be able to lobby for DA efforts and resources for

sanitation, carry out planning and administrative tasks to support the programme, serve as the

communication link with all stakeholders in the district, advocate for CLTS methods, and

provide supervision and support for EH field staff and other facilitators.

Detailed Tasks:

Prepare District Environmental Sanitation Strategy and Plan

Prepare annual sanitation plan e.g. communities to be triggered and supported

Prepare regular sanitation reports

Organise initial training and refresher training for facilitators and natural leaders

Supervise and support the work of EH field staff and other facilitators

Inform and consult DA structures, e.g. Full Assembly, EH Sectoral Committee

Coordinate and liaise with CWSA, NGOs, and external agencies

Facilitate contracting of training service providers

Manage funds allocated for sanitation

Trouble-shooting - help solve conflicts and problems at different levels

Data collection, monitoring and evaluation

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2.4 Environmental Health & Sanitation Unit

(EHSU) Who?

Environmental Health staff operating at district and zonal levels

Role Description:

EHSU is the department within the DA which is responsible for sanitation issues. EHSU field

staff are based at the zonal level and play a key role in the implementation of the CLTS

program, They make regular visits to inform and advise communities on sanitation, check on

the work of Facilitators and Natural Leaders, and monitor the community’s progress in

achieving ODF status. They work under the supervision of the DEHO.

Detailed Tasks:

a) Collect data on sanitation levels and coverage and develop a data base/inventory

b) Promote awareness on the CLTS approach and facilitate community demand

c) Help prepare District Environmental Sanitation Strategy and Plan and Annual Plan

d) Supervise and monitor the work of Facilitators and Natural Leaders

e) Trouble-shooting - help solve conflicts and problems at village level

f) Organise monitoring and evaluation of CLTS projects

g) Provide continuous backup support to communities

h) Prepare reports on field and other activities

Special Note:

Many EH field staff have been trained as CLTS facilitators and are directly involved in pre-

triggering, triggering activities, and follow-up support to communities.

2.5 District Water & Sanitation Team (DWST) Who?

A small team consisting of three field workers –

Environmental Health field worker

Community Development field worker

Someone with technical skills

Role Description:

DWST is the DA’s full time field team working on W&S issues.

DWST members make regular visits to communities to inform

and advise communities on W&S issues, check on the work

of Service Providers, and monitor community progress in

improving water and sanitation. As part of these visits the DWST can help to support and

monitor the communities’ efforts to improve sanitation (stop OD and build to ilets).

Detailed Tasks:

Collect and analyse data on W&S service levels, water points, and needs

Prepare District Water and Sanitation Plan (DWSP) and annual plans

Promote awareness on water and sanitation and facilitate community demand

Supervise and monitor the work of Service Providers

Supervise and monitor Service Providers and extension workers

Trouble-shooting - help solve conflicts and problems at different levels

Organise monitoring and evaluation of W&S projects

Provide continuous backup support to communities

Coordinate and liaise with CWSA, NGOs, external agencies

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2.6 District Assembly Members Who?

Elected politicians, each of whom represents an electoral area. DA members serve on the Full

Assembly, DA committees, and Area Councils.

Role Description:

DA members play two roles in the National Sanitation Program -

a. As community leaders in their own areas they help to explain the NSP, encourage

communities to participate, and support community efforts to achieve ODF status.

b. As policy makers in the Assembly they help to develop sanitation plans and by-laws,

select communities to be assisted, and monitor progress.

Detailed Tasks:

- Participate in framing policies and by-laws on sanitation

- Approve District Environmental Sanitation Strategy and Plan and Annual Plans

- Inform communities about CLTS programme and how they can participate

- Encourage communities to achieve their deadlines for toilet construction

- Monitor progress at the community level and help to solve conflicts

- Serve as role models by being the first to construct latrines

2.7 District Inter-Agency Coordinating

Committee Who?

This committee is responsible for coordinating implementation of the CLTS program. Its

members are drawn from different agencies based at the district level – EHSU, CWSA, RPCU,

DCD, SHEP, EPA, GHS and ISD. DICC is chaired by the EHSU.

Role Description:

Committee members can play different roles in the CLTS program:

- COMMUNITY DEVELOPMENT DEPARTMENT can mobilise communities to participate

in CLTS triggering, support follow-up; and help train Facilitators and Natural Leaders.

- GHANA EDUCATION SERVICE has a program to promote hygiene education in the

schools (SHEP); teachers can help with community mobilisation to stop OD.

- ENVIRONMENTAL PROTECTION AGENCY can advocate for environmental issues.

DICC meets regularly to develop policies and plan and review progress on CLTS.

Detailed Tasks:

- Provide input for and approval of District Environmental Sanitation Strategy and Plan

- Participate in promotion campaigns to inform communities about CLTS

- Approve the list of prioritised communities to be assisted

- Monitor use of funds allocated for sanitation development

- Review implementation progress and facilitate problem solving

- Develop bye-laws to support sanitation development at the community level

- Foster involvement of private companies and NGOs as sanitation service providers

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2.8 Traditional Leaders, Area Council and Unit

Committees Who?

TRADITIONAL LEADERS are chiefs, headman and other traditional leaders.

AREA COUNCIL consists of Assembly members and Unit Committee representatives for an

area covering a number of villages or sections of a small town.

UNIT COMMITTEE is made up of elected and appointed representatives from a single village or

section of a small town.

Role Description:

TRADITIONAL LEADERS: Traditional leaders can play a huge role in the CLTS mobilization

process – speaking out in favour of the approach, condemning open defecation, serving as role

models (who build toilets), providing support and encouragement to Natural Leaders, helping to

get community agreement on by-laws, ensuring that by-laws and sanctions are applied, and

holding the community to their deadlines to achieve ODF status.

AREA COUNCIL and UNIT COMMITTEES are local committees which help with development

planning and mobilisation:

AREA COUNCIL can provide support for the triggering process and follow-up action.

UNIT COMMITTEE is the overall development authority for a single village or section.

Detailed Tasks:

Inform communities about CLTS and how they can participate

Mobilise communities to participate in the triggering process

Monitor progress in sanitation action and help to solve conflicts

Provide support and encouragement to Natural Leaders

Special Note:

The Unit Committee has a broader mandate than the WSMT which is solely focused on water

and sanitation issues.

2.9 Water & Sanitation Management Team (WSMT) Who?

A committee formed by the residents of a small town to plan and manage Water and Sanitation

on their behalf. WSMT is usually made up of representatives of watsan Committees for each of

the taps/standpipes in the small town piped system.

Role Description

WSMT manages water and sanitation on behalf of the residents of the small town. They could

play a major role in planning and supporting the CLTS process.

Detailed Tasks:

Register/indicate community demand to participate in the CLTS process

Help to mobilise community members to attend triggering meetings

Support the triggering process and help to monitor post-triggering action

Serve as models for post-triggering action, i.e. to build their own toilets

Help to establish by-laws to stop open defecation

Organise regular meetings with the community to review post triggering action

Provide support and encouragement to Natural Leaders

Special Note:

WSMT is made up of representatives of different neighbourhoods or sections in the small town.

These neighbourhoods could provide the basis for separate triggering meetings.

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2.10 Community Who?

Residents of a small town. In the case of a small town piped system the “community” would

involve several neighbourhoods or sections within a single town.

Role Description:

The “community” are the primary focus and participants for the CLTS process. They attend the

triggering meeting and then take action to stop OD and build and use toilets.

Detailed Tasks:

Register their demand to participate in the CLTS process

Take part in the triggering meeting

Select and support Natural Leaders

Plan, finance and construct their own household toilets

Construct handwashing facilities

Use, clean and maintain new toilets

Develop regular practice of handwashing at critical times

2.11 Community Facilitators Who?

Environmental Health field workers and other extension workers who receive special training on

how to facilitate CLTS triggering meetings and follow-up visits, and then start doing this on a

regular basis.

Role Description:

Conduct community triggering meetings and follow-up visits designed to help communities move

towards ODF status.

Detailed Tasks:

Enter the community and introduce the CLTS process.

Establish good relations with communities and community leaders

Collect baseline data on community with help from Unit Committee and WSMT

Build active participation by everyone, including women and people with disabilities.

Conduct advance meetings to prepare the community for the triggering process

Facilitate the triggering process, leading to a community decision to stop OD

Facilitate community selection of and support for natural leaders – both men and women.

Support the development of action plans to stop OD and promote toilet building

Provide follow-up motivational and technical support for community action

Facilitate linkages with sanitation product providers and businesses

Promote improved sanitation and hygiene practices e.g. use of latrines and handwashing

Work with others - District Facilitation Team, Environmental Health and CWSA staff, etc.

Prepare work plans, write reports, and conduct monitoring and evaluation

2.12 Natural Leaders Who?

Community members who work as volunteers to lead

the follow-up action process after triggering. They include both men and women.

Role Description:

Make household visits to encourage community members to build and use toilets and organise

other activities aimed at stopping OD and promoting the construction of toilets and handwashing

facilities.

20

Detailed Tasks:

Develop action plans to mobilise the community to

achieve ODF status

Serve as role models themselves by building toilets

in their own homes

Make visits to other households to encourage

everyone to build latrines

Encourage group efforts – neighbours helping each

other to dig pits and build toilets

Mobilise groups to collect indigenous building

materials, e.g. poles and thatching grass

Help poor, elderly or disadvantaged households to

build toilets

Encourage the community to set rules or by-laws to stop open defecation.

Document progress on building toilets (recording completed toilets on community map).

Promote improved sanitation and hygiene practices, e.g. use of latrines and handwashing

Work closely with Facilitators and sanitation service providers

Special Note:

Natural Leaders are volunteers. They are not paid. They do this job out of a sense of satisfaction

and the respect they get from fellow villagers. So don’t pay them - you won’t be able to sustain the

payment nor get the best out of them that way. Instead encourage the Natural Leaders by praising

their efforts, reminding them about the results of their hard work, and getting them to work together

and support each other as a group.

2.13 Sanitation Service Providers Who?

Private sector businesses and skilled latrine artisans. These organisations are expected to

deliver goods and services to communities to support development of sanitation facilities.

Role Description:

Provide services to communities in the following areas:

Latrine construction

Sanitary products e.g. slabs

Detailed Tasks:

Visit the community and market their products or services

Provide specific services over a specified period

Special Notes:

District Assembly should publicize the new opportunities in the sanitation sector and encourage

these organisations to register themselves; or in some cases to formalise themselves as

organisations and businesses.

2.14 Development Partners Who?

NGOs (APDO, CARE, Water Aid, World Vision, New Energy) and External Support Agencies

(e.g. UNICEF, AFD, CIDA, DANIDA, IDA) who are supporting sanitation within the district

Role Description:

Some development partners also initiate their own WASH projects within the district. Often they

take on the planning and implementation of WASH projects covering a number of villages, and

including the use of CLTS. They need to be kept informed about the National Sanitation

Program and how it is being implemented at the district level so they can promote the same

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policies and play a supportive/ collaborative role.

Detailed Tasks:

Conduct training for CLTS facilitators

Collect data to produce sanitation data base

Participate in development of District Environmental Sanitation Strategy and Plan

Help to promote the CLTS approach at community level

Monitor progress at the community level and help to solve conflicts

Special Note:

Some NGOs may also operate as Service Providers (TAs), e.g. providing community

development, training, or technical services. The Assembly should register all NGOs who are

operating in the district and establish a directory/list of NGOs. (Some Assemblies appoint a

NGO Desk Officer to organise this task.) This will make it easier to contact NGOs for

stakeholder and other meetings.

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3. Chapter 3 - Managing CLTS

Program in Small Towns: Project

Cycle

3.1 Introduction This chapter describes how you can plan and manage the small town CLTS program. It describes

activities at each step in the process of starting and developing a CLTS project for small towns in

your district.

The activities are done by different players since sanitation development is a partnership

process. Some activities are done by EHSU and other agencies, others by the community and

Natural Leaders, and others by private sector Sanitation Service Providers.

The Project Cycle provides a step-by-step guide for you, the community, and other stakeholders,

but it is meant to be used flexibly. Some communities are more committed than others, and will

move at different pace. For certain steps some communities may require several meetings to

reach a clear agreement while other communities may need only a single meeting.

The Project Cycle in outline is given below. The rest of the section gives a detailed description of

each step in the project cycle.

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PROJECT CYCLE

STEP ACTIVITY SUB-ACTIVITIES

1 BUILD SUPPORT WITHIN

DISTRICT ASSEMBLY

a. Brief DA Executive and core members on program

b. Organise orientation workshop for DA members

2 ORIENT STAKEHOLDERS

& ESTABLISH DICC

a. Organise orientation workshop for stakeholders

b. Form District Inter-Agency Coordinating Committee

3 COMMUNITY PROMOTION

TO TRIGGER DEMAND

a. Orientation workshop for ‘promoters’

b. Information campaign through public meetings

4 APPLICATION AND ACTION

BY COMMUNITY

Town meeting to:

a. Discuss sanitation program

b. Complete application form

5 SELECTION OF SMALL

TOWNS

a. Check that information is correct and complete.

b. Decide on programme scale & criteria

c. Select participating towns using criteria

6 SELECTION & TRAINING

OF COMM FACILITATORS

a. Select teams for each of the small towns

b. Training – one week workshop + follow-up practice

with coaching/mentoring

7 PRE-TRIGGERING TOWN

MEETING AND BASELINE

DATA COLLECTION

Town meeting to:

a. Trigger strong reaction to OD by town leaders

b. Build commitment to objective of making town ODF

c. Agree on sections in which triggering will be done

d. Develop schedule and organisation for triggering

Baseline data collection – OD profile and number

and condition of HH and public toilets

8 SECTIONAL TRIGGERING

MEETINGS

Organise triggering meeting in each section to:

a. Trigger strong reaction to OD by community

b. Build awareness that we are “eating our own shit”

c. Develop commitment/plan to stop OD & build toilets

d. Identify Natural Leaders to lead the process

9 FOLLOW-UP SUPPORT

AND MONITORING

Regular visits by Facilitators and EHSU Supervisors to:

a. Support work of Natural and community leaders

b. Support and encourage individual households

c. Observe & check on progress – no. of toilets built

d. Provide technical information on toilet building

e. Facilitate by-laws to stop open defecation

f. Make links with sanitation service providers

g. Promote on-going sustainability of new sanitation

facilities and practices

10 ODF VERIFICATION,

DECLARATION, AND

CELEBRATION

a. Community declares it is ODF

b. DA sends team to check that community is ODF

c. Public celebration to recognise achievement

11 SANITATION MARKETING a. DA/EHSU encourages local suppliers to stock

sanitation supplies

b. DA/EHSU trains local artisans and encourages them

to market their services to communities

12 MONITORING,

EVALUATION, AND

REPORT WRITING

a. EHSU sets up results-based M&E system involving

communities, CFs, and EHSU

b. EHSU prepares quarterly, semi-annual, and annual

reports and submits to National EHSD

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3.2 Build Support within District Assembly Introduction

The District Assembly is the home for the small towns sanitation project so the starting point is to

get the DA executive and members fully understanding and supporting the project and its aims.

The District Assembly has the mandate to provide for the sanitation needs of the population. So

involving the DA – both staff and members – is a crucial thing to do. The DA executive and DA

members can lead the efforts to mobilise communities to abandon open defecation – they can

speak out on this issue and they can lead by example.

In the NORST pilot project the District Assemblies were encouraged to provide gender

friendly toilets and urinals on their premises. These were effectively used and

maintained to serve as good examples for their communities. This is one example

where the full support of the Assembly helped to drive the success of the project.

Getting DA members to fully understand the project and its policies is very important so

that they advocate on its behalf and support its policies. During the pilot project some

DA members were not fully briefed on the project so they saw the project as an

opportunity to make political gains. They visited one of the towns and promised to

provide free public and household latrines. The offer of free toilets goes against the ‘no

subsidy’ principles of CLTS and in this case contributed to the slow uptake of the

project in this town – people expected free toilets so they waited, rather than taking

action themselves.

DA members have an important role to play in the CLTS program. As community leaders they

help to explain the program to the small towns in their constituency and encourage communities to

register their interest/demand. As policy makers in the DA they help to develop sanitation plans,

select communities to be assisted, and monitor progress.

Who Participates?

DCE, DCD, Presiding Member, DA Core Staff, DA members

Who Facilitates?

Regional and District Environmental Health Officers and RPCU

Objectives:

Build understanding of the small towns CLTS program - objectives, policies and strategies

Secure the full commitment of the DA to the CLTS small towns program

Review the status of sanitation in the small towns of the district

Major Outputs:

DA Executive, Core Staff, and DA members are aware of CLTS small towns program, how

communities can participate, and the roles of the DA and EHSU

DA Executive and members are fully committed to the small towns sanitation program

Indicators:

Sanitation is a regular item on the agenda of the WASH Sector Sub-Committee

DA members regularly inform and help small towns participate in the program

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Steps/Activities:

1. Discuss the idea of a small towns sanitation program (using the CLTS approach) with the DA

Executive and core staff – and get their full support/commitment.

2. Organize an orientation workshop for all District Assembly members. Use the workshop to

introduce the Small Towns sanitation program, how small towns can participate, and the role

of the DA in organizing and supporting community CLTS action.

3. Discuss how DA members can prioritize action on small towns sanitation - for example:

a) Make sanitation a regular item on the agenda of the WASH Sector Sub-Committee;

b) Put sanitation into the DA’s own budget (District Development Fund);

c) Set targets for sanitation development – number of towns to be supported each year; and

d) Organize campaigns to inform small towns about the CLTS program.

TOPICS FOR ORIENTATION OF DISTRICT ASSEMBLY MEMBERS

Status of sanitation and hygiene in the district (SWOT Analysis)

CLTS Small Towns program - goals, strategies, players and roles, project cycle

How communities can participate and how DA members can assist

Criteria for small towns selection

Roles of DA members and the WASH Sector Sub-Committee

How DA can prioritize action on sanitation and hygiene

3.3 Orient Stakeholders and Establish Inter-

Agency Coordinating Committee

Introduction

The Small Towns Sanitation Program involves a large number of stakeholders - communities,

different government agencies, NGOs, private companies, and others. The EHSU is expected to

coordinate the participation of these different players. They need to ensure that all stakeholders

understand the program and its policies so that they can participate effectively, feel a sense of

ownership, and agree to the policies (e.g. no subsidies).

Who Participates?

EHSU, CWSA, DCD, GES (SHEP), GHS (Health Promotion Unit), EPA, ISD, NGOs, etc.

Who Facilitates?

Regional and District Environmental Health Officers and RPCU

Objectives:

Raise awareness on Small Towns sanitation program, policies, roles, and responsibilities

Facilitate sharing of information among stakeholders on plans and activities

Involve stakeholders in preparation of District Environmental Sanitation Strategy & Plan

Develop plans for implementing the Small Towns sanitation program and allocate roles

among members of the District Inter-Agency Coordinating Committee

Promote and ensure compliance with policies by all stakeholders

Encourage coordination among NGOs and other players at district level

Major Output:

Awareness of Small Towns Sanitation Program and how stakeholders can participate

Commitment to working together in a coordinated way using common approaches

District Environmental Sanitation Strategy & Plan

Agreement on roles of each agency in implementing the Small Towns sanitation program

26

Indicators:

Regular meetings of stakeholders – District Inter-Agency Coordinating Committee

Each agency takes responsibility to implement its own roles/tasks

Steps/Activities:

1. Organize an orientation workshop for stakeholders - see topics below.

2. Use the workshop to start the process of getting stakeholders to meet regularly to share

information and to plan together, as the District Inter-Agency Coordinating Committee.

3. Get stakeholders to meet together on a regular basis, as District Inter-Agency Coordinating

Committee, so that they know what each other is doing and can support each other’s efforts.

Extra Note: The coordination of different stakeholders is not a one-time activity – it is ongoing.

The work of different players needs to be carefully coordinated so that their inputs are introduced

at the right time and reinforce each other. The District Inter-Agency Coordinating Committee

should meet on a regular basis (e.g. monthly) to report on progress and coordinate inputs. Each

agency would give a brief verbal and written report (targets - what done/not done, problem areas

requiring help, targets for next month). This regular meeting would ensure that each agency

knows what the others are doing and can build linkages between different components of the

project.

TOPICS FOR ORIENTATION OF STAKEHOLDERS

Status of sanitation and hygiene in the district

Stakeholders’ objectives and activities in sanitation and hygiene

Small Towns Sanitation Program - goals, policies and strategies, project cycle

Criteria for small towns selection

Roles of stakeholders in Small Towns Sanitation Program

Action planning

The District Resource Book for Scaling up CLTS, Hygiene, and Sanitation Marketing (2011) calls

this type of workshop a “whole system in the room” workshop – a process which builds

consensus on how to implement the project.

Roles Allocated to Different Agencies – Example

Agency Roles

EHSU Coordination and leadership. Data collection. Training and

supervision of CLTS Facilitators. ODF Verification. M&E

RPCU Coordination and planning

CWSA Coordination and technical advice

GES/School Hygiene

Education Project

(SHEP)

Training of teachers on SLTS. Mobilization of students on

SLTS Monitoring. ODF validation.

Department of

Community

Development (DCD)

Mobilize communities for CLTS. Monitoring. Some CD field

staff trained as CLTS facilitators.

APDO Training of CLTS facilitators. Operational research. M&E

EPA Data collection and monitoring of environmental impacts.

GHS – Health

Promotion Unit

IEC programs emphasizing CLTS principles. Programs to

promote S&H behaviour change.

Info Services

Department

Information dissemination and coordination

27

3.4 Community Promotion to Trigger Demand Introduction

The next step is to inform communities about the Small

Towns Sanitation Program and encourage them to register

their interest/demand by completing an application form and

demonstrating their seriousness about improving their

sanitation. This involves an information campaign of

community meetings and flyers. Before the campaign starts,

the ‘promoters” are trained in a workshop.

Who Participates?

Promoters - EHSU field workers, CD field staff, DA members

Participants - chiefs, WSMT members, sectional representatives, Unit Committees

Objectives:

Facilitate self-assessment of the OD situation by the community

Raise awareness about small towns sanitation and how community can participate

Promote interest in and demand for improved sanitation

Encourage small towns (WMST) to apply by completing the application form

Major Outputs:

Awareness of Small Towns Program and what communities need to do to participate

Flyers and application forms in people’s hands

Communities and WSMTs are starting to think about how they can respond.

Indicators:

Formal request from community describing their commitment to improving sanitation

Materials:

Information Flyers and Application Forms

Steps:

1. Training Workshop for Promoters

First train the promoters – DA members and EHSU field workers. Organise a workshop to

explain the basic messages and help promoters prepare for the community meetings. (The

briefing of DA members could be part of the orientation workshop described in 3.1.)

TOPICS FOR TRAINING WORKSHOP FOR PROMOTERS

Small Towns Sanitation Program - goals, strategies, players and roles, and project cycle

Promotion campaign and role of ‘promoters’ in disseminating information

How communities can participate - application forms, criteria for selection

Typical questions that communities might ask and how to respond

2. Information Campaign by Promoters

Having been trained, the ‘promoters’ will then organise follow-up meetings in each town. To

prepare for each meeting:

Invite the chief and elders, WMST, and Unit Committee members.

Make a special effort to invite and involve women, e.g. contact women’s groups.

Encourage representation from all sections of the small town.

28

In conducting each meeting use the agenda and the notes given below.

AGENDA FOR PROMOTION MEETING:

Ask the community to talk about and assess their own sanitation situation first – focusing on

open defecation and the condition of public and household latrines.

Then explain Small Towns Sanitation Program – see notes below.

Then explain what the community has to do to participate in this programme.

Invite community members to ask questions to clarify things.

Ask WSMT and the community to hold their own meeting to: a) decide on what they want to

do to improve sanitation, and b) complete the Application Form.

Hand out the Flyers and Application Forms.

PRESENTATION ON SMALL TOWNS SANITATION PROGRAM

Objectives: To eliminate open defecation, build latrines, and improve hygiene practices.

Old System: In the past government and donors took the lead role in providing sanitation –

offering subsidies or providing materials for toilets, so often the toilets got built but were not used.

In the old approach to sanitation, government worked with individual households and there was

little effort to get the whole community working together on the issue of sanitation.

New Approach: In the new approach the community will take a lead role in mobilising everyone

to take action on sanitation. The community will meet and decide what it wants to do as a

community to stop OD and build toilets. Government now recognises that communities can

organise together to make improvements in sanitation through their own ideas and efforts.

How to Participate? You will be assisted to improve your sanitation but you need to show your

commitment - to show that you are really serious about improving your sanitation. To do this you

will need to complete an application form in which you will show why your community should be

selected for the sanitation program.

Whole Community Involved: You need to start thinking about how you can get the whole

community involved – every section. We can only make a difference in our sanitation and health if

every household commits itself to stopping open defecation and builds a toilet.

Women playing a lead role. Women manage sanitation and hygiene at the household level. So

they know a lot about sanitation and have the most to gain from improved sanitation. So their

active participation, along with the participation of men, can help to ensure that communities

reach the goal of stopping open defecation and building 100% household toilets.

The program is NOT FREE. When materials are given out free of charge, there is no sense of

ownership and often the toilet is not used. So our program depends on each household financing

and building its own toilet, not waiting for government to provide a subsidy or materials. If people

pay for and build their own toilet, they will have a stronger sense of ownership.

After building toilets, households will also be encouraged to use them regularly and develop a

regular habit of HANDWASHING.

Not all communities will be selected. The Assembly cannot work with all communities at the

same time. Some may not be successful this year.

If you are successful, Facilitators will be assigned to work with you to discuss the sanitation

situation in your community and what you want to do about it.

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3.5 Application and Action by Community Introduction

The next step is for the leaders of each small town to meet

on their own, discuss the issues and how they are to

satisfy the conditions, and complete the application form.

This meeting would be organised by the chief and WSMT,

with the help of the local Environmental Health staff.

Who Participates?

Chief, WSMT, sectional representatives, Unit

Committee, DA members, EH Assistants

Objectives:

Increase awareness of the CLTS concept and what it means in practice

Facilitate discussion on how the community can demonstrate it is organised to mobilise

everyone and committed to the objective of creating an ODF community

Complete the application form

Major Outputs:

The whole community is aware of and committed to creating an ODF community

Application form has been completed and sent to the District Assembly

Specific actions to prepare for the triggering process – selection of a small team of men and

women to mobilise participation in the sectional triggering meetings. (This group would work

with the Community Facilitators.)

Indicators:

Formal request from community describing their commitment, capability, and willingness to

mobilise the whole community to participate in actions to create an ODF community

Steps:

1. Town Meeting

Town leaders (chief, WMST, sectional representatives) will meet to discuss how they can

participate in the Small Towns Sanitation Program and complete the application form. After

the meeting the WSMT will complete the application form and send it to the District Assembly.

AGENDA FOR TOWN MEETING

Sanitation and Hygiene

Sanitation - How do people dispose of faeces? Is that a problem? How many people own

and use latrines? What condition are they in? What can we do to encourage people to

stop open defecation and build/improve/use latrines?

Hygiene – How often do people wash their hands with soap? What are the major barriers

to this practice?

Community Organisation

How will the community organise every household to stop open defecation and take an

active part in building toilets?

How to select a working group in each section made up of men and women to organise

community meetings to discuss and take action on sanitation?

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3.6 Selection of Small Towns Introduction:

Once application forms have been received, EHSU will verify each application form. Then the

District Inter-Agency Coordinating Committee and the Assembly will meet and decide which

towns should start the programme.

Who Participates?

EHSU, District Inter-Agency Coordinating Committee, DA Sectoral Subcommittee

Objectives:

Check that Information in the application form is correct and complete

Select a number of small towns who will be invited to participate in the programme

Major Outputs:

Verified application forms, i.e. the level of commitment/demand is assessed

Prioritised list of small towns – selected through a transparent process

Materials:

Verification Checklist

Criteria for town selection

Steps:

1. Desk and Field Verification:

EHSU staff will review the applications and identify gaps in information to be checked in the

field. Then they will visit the towns to verify that the information is correct and complete.

VERIFICATION CHECKLIST:

All items on the Application Form have been completed.

Information has been discussed with and agreed by a representative body of community

members (who are aware of its contents).

Sanitation is a priority need expressed by the community.

Community have shown their willingness to mobilise everyone to participate.

List of sectional leaders to organise the triggering meetings.

2. Selection of Participating Small Towns

District Inter-Agency Coordinating Committee decides on:

a) Scale of programme - proposed number of small towns to be assisted over a two year

period (based on the EHSU’s financial and staffing capacity); and

b) Assessment criteria to be used in selecting communities.

31

In deciding on the scale of the program, you should take into account:

How many small towns the EHSU and its partners can support at one time;

The number of other activities that EHSU and its partners are working on;

The size of the towns which are selected;

How many teams of trained CLTS Facilitators are already available or can be trained (to

do triggering and post-triggering follow-up visits); and

District politics. Some DAs may decide to spread investments around the district in order

to avoid being accused of favouring one area over another. Other districts may choose to

concentrate work within one or two areas/zones which have been neglected. This would

make supervision and monitoring easier and more cost effective.

3. Preparation of Short List

Using criteria, the District Inter-Agency Coordinating Committee assesses each application,

e.g. ‘high, medium, or low’. Then they draw up a shortlist of small towns to be assisted.

4. Approval by Sectoral Subcommittee and Full Assembly:

a) Sub-Committee reviews the list of priority towns and confirms or modifies the list.

b) Full Assembly gives final approval to the list of prioritised towns

5. Official Notification

Small Towns are informed about the results of the selection by a letter from the District

Assembly. Other notices are placed on the Assembly notice board.

CRITERIA FOR COMMUNITY SELECTION

Background Factors

Population of small town

Availability of potential of safe water supply

What sanitation facilities does the community have already?

What sanitation facilities (public and household latrines) are already available in small town -

Number of facilities? Type of facilities? Condition and cleanliness? Use?

What is the ratio of toilets to population?

Is there a strong community demand?

Indicators of community demand and interest might include:

Is sanitation top priority, or are other services (e.g. schools) considered more important?

What efforts have already been made by the community to improve their sanitation, e.g.

construction and/or maintenance/repair of public latrines?

Level of community interest and commitment (e.g. number of people who attended and

participated actively at community meetings to discuss the sanitation program)?

Can the community manage sanitation action to achieve 100% toilets?

Indicators of community management capacity might include:

Number of other community projects and how well maintained?

Level of women’s participation in managing community projects?

Leadership strength of Watsan Committees in each section of the small town?

Are lots of people suffering from sanitation related diseases?

This is another indicator of the status of sanitation. Those communities which practice mainly

open defecation will often have high levels of diarrhoea and cholera.

32

Are there lots of conflicts and disputes?

The success of the CLTS approach depends on full community participation, so it will be difficult

to implement projects in communities involved in disputes over chieftaincy, land, or ethnic issues.

Community members who are living in fear (e.g. minority groups and women), will find it difficult to

participate actively in the CLTS process. If you are aware of any such dispute, then set the

community aside until such time as it is resolved.

Note: Kamal Kar, the founder of the CLTS process, has recommended the following guidelines in

deciding which communities to start in:

Select and start CLTS in more favourable communities first, i.e. no major conflicts.

Establish successful outcomes, gain experience, and tell the success stories.

Build confidence of the key actors and move on to other communities.

Use Natural Leaders in successful communities to help spread CLTS to other areas.

3.7 Selection and Training of CLTS Facilitators Introduction:

The next step is to select and train CLTS Facilitators needed to carry out triggering and follow-up

activities in each of the small towns selected. Environmental Health Assistants should be the

major target for this training because sanitation is a major part of their job description, and they

are located at the zonal level and available to do the triggering and follow-up promotion.

Who Participates:

EH Assistants, DWST members, other extension workers, NGO field workers

Who Facilitates:

Experienced trainers drawn from EHSU and NGOs (e.g. APDO)

Objectives:

Select field workers with the right skills and attitudes to become CLTS Facilitators

Develop hands on skills in facilitating the CLTS triggering process and follow-up support

Develop teams of facilitators who would work together in doing triggering and follow-up

Major Outputs:

Full understanding of CLTS approach – objectives, principles, strategies, key messages

Practical skills and confidence to facilitate the ten CLTS triggering activities

Skills to organise pre-triggering community visits and post-triggering follow-up visits

Steps/Activities:

1. Selection: EHSU will select 6-8 field workers (from EHAs and extension workers) for each of

the towns they want to work in – to attend the training. Out of the training roughly 4-5 field

workers will emerge with the necessary skills and confidence to do triggering in a single town

– and this group will form a triggering team. After the training the team will organise triggering

meetings and follow-up visits in the small town – working in each section. Depending on the

size of the towns, one team might trigger in a single town or if the towns are small and close

together, they might cover more than one town.

CLTS requires a gender sensitive approach so roughly half of the workshop

participants and the new training teams should be women. Female CFs find it easier to

encourage the active participation of women in the triggering discussions and in follow-up

action.

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2. Training: Training will be organised as a two step process:

a) 6 day workshop in which trainees learn hands on skills through lots of practice (with

feedback) at the workshop centre and in two practice communities; and

b) Follow-up mentoring – trainees will start to organise triggering in different sections

and be accompanied by one of the trainers who will serve as a coach (providing on-the-

job advice and feedback).

Special Note: Training is needed at the start of the CLTS program to ensure there are

enough dedicated facilitators with the necessary skills. However, ‘refresher’ training will

be needed on an ongoing basis year after year to replace those who drop out and

strengthen the skills and confidence of all of those involved.

NORST discovered that this type of refresher training is also needed to ensure that all

the facilitators are using the same triggering approach, i.e. applying the best practice

and learning from each other.

OUTLINE DESCRIPTION OF TRAINING WORKSHOP FOR CLTS FACILITATORS

The workshop is a 6 day workshop to train facilitators for CLTS triggering and follow-up. It

includes 4 days at the workshop site (Days 1-3 and 6) and 2 days in nearby communities (Days

4-5) practising what has been learned in the workshop.

The workshop is built around demonstration and practice of the Ten Triggering Steps.

Participants will first observe the trainers demonstrating how to facilitate this process and then

practice it themselves. Each practice session will focus on a single activity in the process. After

each practice session trainers will provide feedback to help trainees improve their skills and

confidence in facilitating the activity. This process of demonstration and practice will allow

trainees to get a ‘hands on’ understanding of the CLTS triggering process – through:

a) participating in triggering sessions run by the trainers and observing how they “do it”;

b) preparing and facilitating their own triggering activities as facilitators (with feedback); and

c) observing the practice sessions of other trainees (and providing feedback).

During the practice sessions trainees will learn three sets of skills:

a) Facilitation techniques – asking open and probing questions, rephrasing, etc;

b) How to facilitate each triggering activity, step by step; and

c) Responding to difficult/challenging questions from the community.

This process will allow for 4 ½ days of practice of the triggering activities – 2 ½ days in the

workshop site and 2 days in the field. The demonstration and practice sessions will be built

around the activities in the CLTS TRIGGERING GUIDE Each trainee will be given a copy of the

guide and asked to read it each evening, and will use the guide for practice sessions.

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The workshop will be organised in six major phases or blocks of activity:

No. Timing Topic Detailed Description

1 Day 1

CLTS Approach +

facilitation skills

Introduction to CLTS principles, strategies, roles, and

key messages + practice on facilitation skills

2 Day 2 am Demonstration on

Triggering Steps

Trainers demonstrate the CLTS triggering activities +

debriefing after each to emphasize key features.

Aim: to provide a model for trainees to replicate.

3 Day 2 pm

Day 3 am

Practice Rounds

with Feedback

Participants practice the CLTS triggering activities,

working in small groups. Trainees try out each

triggering activity, followed by feedback.

4 Day 3 pm Planning and Prep

for Field Practice +

extra practice

Each team will plan for field practice – agreeing on

roles, how to work together, etc. + extra practice on

the triggering activities.

5 Days 4 &

5

FIELD PRACTICE

(work in 2-3 teams

in communities)

Each team will facilitate triggering process in one

community each day (3-4 hour process). After each

practice, team will assess its performance.

6 Day 6 Action Planning Action planning for follow-up visits to pilot

communities + new triggering. Monitoring, ODF

verification. Evaluation + closing.

3.8 Pre-Triggering Planning Meeting (Town Level)

and Baseline Data Collection Introduction: The next step is to organise a planning meeting at the town level (triggering

activities and planning for triggering meetings) and collect baseline data.

Who Participates:

Chief and elders, DA member, Water & Sanitation Management Team, Watsan Committee

members (sectional representatives), women’s group leaders, Unit Committee members

Who Facilitates:

Community Facilitation Team, District Environmental Health Officer

Objectives:

Build rapport/collaboration between town leaders and Community Facilitation Team

Trigger a strong reaction to OD among community leaders

Build strong commitment by town leaders to the objective of creating an ODF town

Agree on the neighbourhoods/sections in which triggering will take place

Develop a plan/schedule for triggering and follow-up action in each of the sections

Identify organising group in each section who will mobilise participants to attend triggering

Collect baseline data (OD profile and number and condition of toilets)

Major Outputs:

Strong emotional reaction to OD by town leaders (disgust and anger)

Plan/schedule for triggering meetings in different sections

Organising group in each section who will help organise the triggering meeting

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Steps/Activities:

1. Town Planning Meeting: The Community Facilitators will organise a 2-3 hour meeting with

key leaders (chief, elders, WSMT, sectional representatives, women’s leaders, etc.).

Agenda

2-3 triggering activities (e.g. Shit Mapping, Shit Walk) to make the leaders aware of the

objectives/importance of the program and to trigger their own strong interest

Program Objectives and Principles – stopping Open Defecation, building toilets and

hand washing facilities, no subsidies, women’s active participation, Natural Leaders.

Project Cycle – pre-triggering, triggering, follow-up – and roles/activities at each stage.

Emphasize the importance of post-triggering follow-up and support for the Natural

Leaders

Deciding on Sections: agreeing as a group on sections/neighbourhoods for triggering

[Follow existing and known boundaries (imaginary or real) in deciding on sections.

This demarcation will follow the same sections used in tap